Why are Black Women Less Likely to Survive Breast Cancer?
I have known many women who have been diagnosed with breast cancer. Fortunately, it has never happened to anyone in my family, but I’ve seen coworkers, friends’ mothers and community members touched by this terrible disease. It is for this reason that I always donate to breast cancer-related charities (especially when my students are fundraising) and why my mother and I have walked in many Avon Walks for Breast Cancer over the years.
Although breast cancer doesn’t discriminate between race or class in who is diagnosed, a new study has shown that black women have a 12.9 percent less chance of surviving a breast cancer diagnosis five years out than white women did. This research, published in the July 24/31 issue of JAMA, was a comprehensive look at racial disparity in breast cancer survival rates in the United States:
The researchers looked at 7,375 black women aged 65 years and older diagnosed with breast cancer between 1991 and 2005 and compared them to 7,375 white patients. The patients came from 16 U.S. Surveillance, Epidemiology and End Results (SEER) sites in the SEER-Medicare database.
All the patients received follow-up care through December 2009. Each black patient was matched to a white patient in three different categories: demographics (age, year of diagnosis and SEER site), presentation (demographics plus co-existing conditions and tumor characteristics) and treatment (presentation plus aspects of surgery, radiation therapy and chemotherapy).
What the research found was shocking. Not only did the study find that black women were less likely to survive a breast cancer diagnosis than white women, but also that this was due in large part to the disparity in treatment that white women received versus what black women received.
Only 5.9 percent of white women in the study did not receive any treatment for their cancer compared with 12.6 percent of black women. Black women were found less likely to start treatment within three months of a diagnosis, and there were 29.2 days on average between the time a black woman was diagnosed until her treatment, whereas there were only 22.5 days for the average white woman.
Considering that The American Cancer Society has found that, when a woman is diagnosed with less advanced stages of breast cancer, the five year survival rate is much higher (93 percent for a stage 0 diagnosis) than that of a later diagnosis (just 15 percent for stage IV), it makes sense that the longer a woman waits between diagnosis and treatment, and the longer it takes a woman to get to the doctor in the first place, the worse the chances are for survival.
Unsurprisingly, according to the “Los Angeles Times,” part of the reason for this disparity might be due to a difference in care. The women studied who were on Medicare had a far greater risk of dying from the disease than those who were not. Also, the more the white women in the study had in common with the black women in the study — from where they lived to how much money they made — the lower the survival gap was. Between white women and black women of the same socioeconomic status and with similar tumors, the gap was just 4.4 percent as opposed to 12.9 percent. When the treatment was also similar, the gap shrank even further to 3.6 percent.
There is no stronger argument than this to show that race and class are important factors in healthcare treatment. As is well documented, the health care system in America has a serious lack of treatment options for those who don’t have the money to pay for them, which often shows in these kinds of results based along racial lines. As a direct consequence of this, an often treatable disease is becoming more deadly for black women than for white women. Breast cancer may not discriminate when it attacks, but we need to look long and hard at how these women have been allowed to fall between the cracks.
Photo Credit: Tips Times